Wednesday, February 08, 2006

Over the last few weeks I've been devoting some attention to private member's bills currently in the ballot. But this one deserves a post all of its own: Peter Brown's Death With Dignity Bill. This was last before the House in July 2003, when it was defeated 60 - 57 on its first reading. But the issue won't go away, and Brown is back for another shot.

The bill itself is virtually identical to the 2003 version. In keeping with NZ First's commitment to direct democracy, it would require ratification by a referendum before coming into effect. If ratified, it would establish a regime whereby a medical practioner could assist a patient suffering from an incurable illness which fundamentally impairs their quality of life, independence or mobility to end their lives (either by prescribing or preparing a substance for self-administration, or administering such a substance. I think most doctors, even those who support assisted suicide, would balk at the latter). There are safeguards built in, including a medical check, psychiatric interview, and a requirement that the witnesses to any request be truly independent. "Advance directives" (otherwise known as living wills are allowed). Finally, it would establish strong provisions against undue influence (5 years in jail and a $250,000 fine), prevent any contracts on the issue (whether contracting to kill yourself or contracting not to), and ensure that any death is treated as a death due to terminal or incurable illness by insurance companies.

How does this compare to laws overseas? Only four jurisdictions currently allow assisted suicide: Oregon, the Netherlands, Belgium and Switzerland. Oregan, Belgium and the Netherlands require the consent of two doctors, and the Netherlands also requires the consent of a psychologist if there are any doubts about competance. Switzerland allows anyone to help, provided it is "altruistic", but in practice voluntary societies such as Dignitas insist on a medical opinion and will refuse to provide lethal drugs if the condition is not terminal. Where the various jurisdictions differ signficiantly is on the method: both Oregon and Switzerland require self-administration, and forbid doctors from actually killing the patient.

The Northern Territory used to allow assisted suicide, under the Rights of the Terminally Ill Act 1995, but this has since overturned by Australian federal legislation. The law similarly required the consent of two doctors, but had no requirement for a psychiatric interview. Compared to these then, the safeguards in Brown's bill seem very robust. Not that that necessarily means they are enough (for some people, no safeguards will ever be enough) - but they compare very well with the overseas examples.

In 1995, Michael Laws' "Death With Dignity" bill was defeated 61-29. In 2003, the margin was 60-57. This time round, I don't think the bill will do quite as well. 43 current MPs voted for death with dignity in 2003, while 48 voted against (though 5 of those had voted for in 1995). And of newly elected MPs, only one has declared that they support voluntary euthanasia, while 5 have declared that they oppose it. That still leaves 24 MPs unaccounted for, of course - but the initial situation doesn't look good. While I think this bill or some variation of it will ultimately succeed, I don't think it'll be this term. That won't stop me fighting for it though.

7
comments:

Read it. I do support such a measure- or something like Oregon's physician assisted suicide bill- but I have to wonder how far it'll get.

In Oregon and the Netherlands, it was the case that medical practitioners organisations were either supportive or neutral on the matter of VES/PAS. The New Zealand Medical Association opposes it. Therefore, it will present formidable odds against the passage of such a bill past the select committee stage*.

Incidentally, I do recommend the Parliamentary background paper on VE myself.

*For the same reason, I suspect that the Bradford anti-beating billwill pass, because there is strong child health and welfare professional support for it doing so.

Craig: I agree. I don't really think the bill will pass until the NZMA is won over. But I still think its important to throw it into the ring and have a crack at it every three years.
Posted by
Idiot/Savant
:
2/08/2006 07:43:00 PM

My gut reation is that we'll get it when health care for the growing number of elderly starts to really pinch the public purse.

The other fear I have is that it will create a psychological/social duty to die for people who are terminal but would quite like to live. Perhaps this could be dealt with by only allowing euthanasia for those who created a living will when they were in good health.

Not to mention that fact that we have legal safeguards to determine who can obtain an abortion, but in reality it is on demand. Who is to say this won't end up like that despite the good intentions of the Bill's creator?

I too believe it will eventually come to be law, but I for one will make sure that I'm down on the "don't pop me off" list.
Posted by
muerk
:
2/08/2006 10:37:00 PM

Muerk:

We already have de facto palliative medication rationing, due to Pharmac's pharmaceutical regulation regime, which imposes obstacles to approval and access to palliative medication due to cost/benefit arguments.

Whatever one's stance on euthanasia, I think we agree that some people who need palliative medication at present aren't getting it.